Individual provider Active NPI

Dallas Cranmore

  • Physical Therapy Assistant
  • Virginia Beach, VA
National Provider Identifier
1033067749
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306606147 Issued in VA
Practice address
4668 Pembroke Blvd Ste 112
Virginia Beach, VA 23455-6423
Phone
(757) 663-7690
NPI assigned
Mar 18, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306606147 VA Primary

Addresses

Primary practice location

4668 Pembroke Blvd Ste 112
Virginia Beach, VA 23455-6423

Mailing address

4668 Pembroke Blvd Ste 112
Virginia Beach, VA 23455-6423
Phone (757) 663-7690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2306606147VAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1033067749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4668 PEMBROKE BLVD STE 112",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556423",
            "telephone_number": "757-663-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4668 PEMBROKE BLVD STE 112",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556423",
            "telephone_number": "757-663-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANMORE",
        "first_name": "DALLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306606147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.